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Cited 1 time in webofscience Cited 2 time in scopus
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Prognosis After Weaning from Respiratory Extracorporeal Membrane Oxygenation

Authors
Yeo, Hye JuKoo, So-MyHan, JunheeKim, JunghyunHong, Sang-BumChung, Chi RyangPark, So HeeYong Park, SeungSim, Yun SuCho, Young-JaePark, SunghoonKang, Byung JuOh, Jin YoungLee, Sang-MinJung, Jae-SeungChang, YoujinYoo, Jung-WanCho, Woo Hyun
Issue Date
Sep-2020
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Keywords
extracorporeal membrane oxygenation; mortality; postweaning; steroid
Citation
ASAIO Journal, v.66, no.9, pp 986 - 991
Pages
6
Indexed
SCIE
SCOPUS
Journal Title
ASAIO Journal
Volume
66
Number
9
Start Page
986
End Page
991
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/32892
DOI
10.1097/MAT.0000000000001107
ISSN
1058-2916
1538-943X
Abstract
Successful weaning from extracorporeal membrane oxygenation (ECMO) does not necessarily imply patient survival. We retrospectively analyzed 441 patients with acute respiratory failure from 16 hospitals in South Korea who underwent ECMO from January 2012 to December 2015. We evaluated the clinical factors associated with mortality after successful weaning from ECMO. Of all 441 patients, 245 (55.6%) were successfully weaned from ECMO. The majority of patients were initially supported with veno-venous ECMO (86.9%). Among those, 182 patients (41.3%) were discharged from hospital. Only 165 (37.4%) were alive after 6 months. Most cases of death occurred within the first month after weaning from ECMO (65%), and the most frequent reason for death was sepsis (76.2%). In the multivariate Cox regression analysis, patient age (per 10 years) (hazard ratio [HR] = 1.34, 95% CI = 1.12-1.61;p= 0.001), sequential organ failure assessment score (HR = 1.07, 95% CI = 1.02-1.13;p= 0.010), steroid (HR = 2.38, 95% CI = 1.27-4.45;p= 0.007), interstitial lung disease (HR = 1.20, 95% CI = 1.05-1.36;p= 0.006), and ECMO duration (per day) (HR = 1.02, 95% CI = 1.01-1.04;p< 0.001) were associated with the in-hospital mortality after weaning from ECMO. Furthermore, age (per 10 years) (HR = 1.45, 95% CI = 1.24-1.71;p< 0.001), steroid (HR = 2.19, 95% CI = 1.27-3.78;p= 0.005), and interstitial lung disease (HR = 1.16, 95% CI = 1.02-1.31;p= 0.021) were significantly associated with 6 month mortality. The prognosis after weaning from respiratory ECMO might be related to baseline conditions affecting the reversibility of the primary lung disease and to acquired infections.
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Jung, Jae Seung
Anam Hospital (Department of Thoracic and Cardiovascular Surgery, Anam Hospital)
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